Illinois WC Preferred Provider Program (PPP) Update

An update on the Preferred Provider Program (PPP) process from the August 23^rd IWCC Workers' Compensation Medical Fee Advisory Board:

Once Governor Quinn signed HB 1698 into law, Illinois employers gained the ability to employ a Preferred Provider Program (PPP) to direct their injured workers to participating providers for treatment.  In order for employers to implement the PPP direction of care process, HB 1698 lists two basic requirements:

1.    The PPP must be approved by the Illinois Department of Insurance (IDOI).

2.    The Illinois Workers’ Compensation Commission (IWCC) must promulgate a notification form that the employer will provide to an employee at the time of injury.

During the 8/23/11 IWCC Workers’ Compensation Medical Fee Advisory Board meeting, an Illinois Department of Insurance representative confirmed that the IDOI is ready to accept PPP applications. 

The applications should follow the same format as the current PPA (Preferred Provider Program Administrator) process, and they should include all of the current PPA requirements along with the new PPP requirements specifically outlined in HB 1698.  As of today, the IDOI website does not have a list of approved, or provisionally-approved, WC PPPs on their website. 

Now that some current IDOI–approved workers’ compensation PPAs, such as HFN, have submitted their PPP applications to the state, the IWCC will need to either create a form, or provide employers the required notification criteria, to fulfill its notification form requirement detailed in HB 1698.

As of the 8/23/11 Board meeting, the Commission did not have a draft of the notification form.  The Board members stated any third parties may submit their proposed drafts of notification requirements to the Board before the next scheduled meeting on September 13.   They will discuss the standards for the notification form again at that meeting.

Once that IWCC notification form is available, employers will be able to utilize their PPPs.

As an Illinois-based and Illinois-focused company, HFN understands the requirements and opportunities for providers and employers specific to the Illinois workers’ compensation system.  For more information about the PPP process, or to designate HFN as your PPP, please email Guy Swanson, HFN’s Director of Workers’ Comp, or call 630.990.8609.